I was thinking of taking Memorial Day off. There are several reasons. First, it’s a holiday. Second, the blog still isn’t functioning quite up to snuff after the transition to WordPress. In particular, we still have a major spam infestation that is unlikely to improve before Tuesday. It also doesn’t help that I have a whole bunch of grant writing to do.

Then I saw this. I became aware of the post through a TrackBack, and that TrackBack came from the website of a rock group—yes a rock group, and a bad one, at that—made up of antivaccine loons. Those antivaccine loons call themselves The Refusers and are known for such gems as Mad Hatter Blues, Vaccine Gestapo, and First Do No Harm. The Clash doing The Guns of Brixton, they ain’t.

For some reason, The Refusers, in all their whacked-out quacky glory, have taken note of little ol’ me. More importantly (and the reason why I felt obliged to apply some Insolence, in this case of the not-so-Respectful variety, to this merry band of ear-splittingly bad antivaccine rockers), Michael Belkin, head Refuser, has attacked my readers. This I cannot abide, even if I could resist an opening paragraph like this?

Message boards on the virulently pro-vax web site ORAC Respectful Insolence advocate fraudulently impersonating disease-injured families and insane people on the comment sections of vaccine injury and vaccine freedom websites such as Age of Autism, Mothering Magazine and Amazon.

These pro-vax maniacs’ purpose in life is to discredit anything that casts doubt on vaccines, which is their pseudo-scientific religion.

“Virulently pro-vax”? Michael Belkin says that as though it were a bad thing.

Personally, I don’t care when an antivaccine loon like Belkin smears me, attacks me, or insults me. I actually rather view it as a badge of honor and am pleased that my efforts are being—shall we say?—appreciated. If they don’t attack me, then I start to worry that my effectiveness in countering their pseudoscience, quackery, and downright idiocy is on the wane. However, when they start attacking my readers? As I said, thato I cannot abide. Belkin is in essence accusing you of lying:

The next time you see comments saying: ‘My unvaccinated child has autism’ or ‘My immune-compromised child can’t take vaccines – it is your duty to immunize your child so my child doesn’t get sick’ or ‘My sister got measles and died’ etc. – please be aware that these may be totally fabricated lies concocted by vaccine fanatics to intimidate and discredit vaccine freedom and awareness websites and facebook pages.

They also advocate setting up phony email accounts and IDs so that their dishonest comments cannot be traced back to the source.

This despicable behavior makes it impossible to believe the veracity of any pro-vax comments you may read on news articles, Amazon forums, Mothering Magazine, etc., where these slimebag commentators lurk.

First off, two out of the three of Belkin’s examples are massive straw men. I don’t know of anyone who’s ever claimed (at least not on my blog) that her sister died of measles or that her unvaccinated child has autism. I don’t recall if anyone’s ever mentioned her immunocompromised child not being able to take vaccines.

In addition, I can’t help but note that Belkin is all about the selective quoting as well. For instance, he cites something g724 says in this post. He completely leaves out g724’s suggestions to send lawyer letters to antivaccine bloggers, siccing the Postmaster General on bloggers advocating sending infectious material through the mails, discontinuing religious exemptions, and developing religious counterarguments to vaccine objections. Instead, out of the many suggestions made in that comment, Belkin zeros in like the proverbial laser beam on one part of the comment, the part in which g724 recommends using emotional warfare over aon antivaccine blogs and going in there agreeing with them but doing so in an overtly “nuts” way.

He then lists a bunch of comments from my blogs, most of them by someone going by the ‘nym of g724. Looking at those quotes, they certainly appear on the surface to be somewhat damning. What Belkin forgets to notice is that the reaction to these suggestions by g724 were uniformly negative. For instance, Antaneus Feldspar writes in the comments (damn the new WordPress not letting me link right to the comment; you’ll have to search and scroll):

Oh, not this from g724 again. I thought he’d finally bought a clue and given up this stupid “let’s win against the antivaxxers with an ethics-free dirty tricks campaign!!” No. We have an advantage that the antIvaxxers cannot match, which is that ours is the one that doesn’t need lies and distortions to support it. There are few stupider ideas anyone could come up with than “let’s do lots of dishonest things to counter the antivaxxers! Let’s post fake messages pretending to be crazy anti-vax conspiracy nuts!” Yeah, that’s a great idea. You know what happens if we do that? Any crazy anti-vax conspiracy crap that comes from anyone other than an established antivaxxer can be written off as “probably just a vaccine pusher up to dirty tricks again.” Yeah, g724, let’s give them plausible deniability; great idea! For the last time, stop with this crap! If you can’t defend science-based medicine with anything except dishonesty, it’s not because antivaxxers are such an unconquerable enemy, it’s because you aren’t up to the challenge; it’s no excuse for stooping.

Denise Walter also commented:

Altho’ your plan has its charm- if you like black ops- I believe that *my* own strong point is that I use my education and experience to expose the blatant lies and posturing by those who rely upon pretense: I can’t do what I’m opposing.

I could probably present myself in a way that might be more appealing to the average alt med-friendly person: I could talk about my (non-existent) children or play down-home girl-next-door but that’s not who I am. Like Antaeus says, we do have something that the woo-meisters don’t: a better grasp on how the real world works.

Belkin’s broadside got me to thinking: Who is this g724 person anyway? I have no idea, but I did decide to do a little searching. Fortunately, even after the messed-up transition to WordPress, all of g724’s comments are still here. So I went looking around on the back channel. The interesting thing I noticed is that this major comment cited by Belkin has a unique IP address that is different from all of g724’s other posts. That makes me wonder whether someone in the antivaccine movement is doing exactly what Belkin claims we are doing. Fortunately for me (and unfortunately for the antivaccine movement), Belkin is so transparent, so utterly obvious, and so utterly clueless, that I have a hard time believing he thinks that this is an effective attack.

Finally, let me just say that, as tempting as it is, I do not support any sort of campaign of the sort proposed by g724. As several of my readers have pointed out, the single biggest advantage that we have is that science is on our side. Snark is OK (as long as it’s science-based). So is laying down the science. We don’t need to lie; we don’t need to pretend to be something we are not; we don’t need to “infiltrate” and try to lay emotional cards. We need to keep reiterating the science and refuting the quackery. True, that’s not enough, at least not in and of itself, but it’s the bare minimum we need as foundation to build on.

Someone put a link about this in the comments the other day. If I remember, another counter to him was actually doing it honestly, i.e., I have a vaccinated child who is not on the spectrum, etc.,

For some reason (and this always baffles me) the millions of children who are completely vaccinated and perfectly healthy somehow “sneaks past” the anti-vax radar and they get completely focused on suspected (unproven) vaccine injury.

There are vaccine injuries. They are quite rare and are acknowledged. When the risk-benefit ratio is analyzed they’re definitely a great choice in medicine.

Maybe I’m a lucky little internet person. A few months before I was offered the vaccine for meningitis for my son I had seen posted several videos by parents who had lost their teenaged children to it. I had no idea another vaccine had been added (don’t keep track of that as much as I expect my doctor to bring it up), and when told that it wasn’t necessarily mandatory yet, I still said, “yes, please.” I don’t need my son to seem to be coming down with the flu and then dead because I didn’t realize until it was too late to treat him that he had meningitis instead.

@Orac – I do believe that one of your older posters did say he/she had a sister die from measles. I want to say it was lilady, since the age range would be right, but I’m not positive (and it may not have been on RI I read the comment). And there was a comment of an immuno-compromised child; again, I’m not sure it was on RI (I read a lot of medical/autism blogs).

As for g724’s comment – I remember reading it and thinking “wow, over the top, here”, reading the wonderful comments by the regulars, and mentally dismissing him/her as an idiot and moving on.

As for The Refusers – well, after trying to listen to them, I’d rather be tied down and forced to listen to rap music. I have limits to my willingness to subject myself to torture, and their “music” is WAY outside my limits.

Oh – and should have added – I don’t sockpuppet. I have 2 names I post under. MI Dawn and triskelethecat, depending on the email address the comments are linked to. So The Refusers can take their comments and run. If I ever posted there, I’d be proud to use my comment name….but I really doubt any comment *I* would make would make it through their moderation process….

@Chris, first I hope your little one is better soon.
I have an autistic child – a vaccinated one and I’ll get this right out in the open I suffered a vaccine related injury: my boy bit me after his second MMR because I wouldn’t let him play with the taps in the treatment room.

I left the following comment on that blog (mistakenly attributing authorship to a Dr. Brownstein):

Dr. Brownstein, It is obvious that you are selectively quoting commentors, but more importantly, it isn’t Orac advocating any such action. In fact, regular commentors are taking those suggesting trolling forums to task. How dishonest of you.

Surprisingly (not) it’s still in moderation while the credulous teeth-gnashers’ comments are being let through. What a sad lot they are.

I’m in Umbria Italy now and posting from a friend’s computer. I’ve only posted in the past about a cousin who was left with permanent neurological sequelae from measles encephalitis. I lost my childhood chum to polio, in the early 1950s.

My son was immune compromised with a bleeding disorder (leukopenia and thrombocytopenia) with a platelet aggregation and adhesion problem, but he was fully immunized…including Heptavax vaccine, prior to his entry into a group home. (There were chronic Hepatitis B carriers in his group home)

First of all, they were able to extract a particular comment that goes against the grain of near- consensus @ RI precisely *because* our esteemed and gracious host ALLOWS dissent

Then, they need to MANGLE even that by leaving out salient features g includes as well as commenters’ objections and predictions..

Next, they LEAD their audience into inferring – on the basis of this cherrypicked paucity – that claims of complications of VPD should be suspect. This is similar to how woo-meisters poison their audience’s reactions against standard sources like the medical establishment, governments, media and corporations by *revealing* the aforementioned’s other dastardly deeds.

The Refusers ( -btw- do their fans call them Refuse for short?) then speak about their *expose*…. Oh Lord, perhaps Jake will write it up @ AoA… Or it might provoke trenchant musings @ TMR? Or better yet, will the band get a *song* out of this? Or an entire album?… I can see it now….*A Well-respected Shill*, *Blog Fighting Man*, *On a Street with No Sense*, *Stairway to Stupid*…

-btw- I never comment on any alt med/ anti-vax sites or woo-leaning ones like HP. Altho’ I survey their blogs, like an observer on an alien world, I do not interact with the resident beings- non-interference policy, you know- *however*, it’s a different story if they land here. And I leave off my second surname.

Oh and I apologise in advance for taking the song titles of various talented gentlemen ( esp Mssrs Davies) in vain.

Lilady, so you are taking a vacay with your ill-gained pharma shill payoffs? Do you have any idea when the checks for the rest of us are coming through?

Now on to facts, rather than fantasy (the pharma shill checks). For those of you who don’t know, a portion of Michael Belkin’s testimony

My daughter Lyla Rose Belkin died on September 16, 1998 at the age of five weeks, about 15 hours after receiving her second Hepatitis B vaccine booster shot. Lyla was a lively, alert five-week-old baby when I last held her in my arms. Little did I imagine as she gazed intently into my eyes with all the innocence and wonder of a newborn child that she would die that night. She was never ill before receiving the Hepatitis B shot that afternoon. At her final feeding that night, she was extremely agitated, noisy and feisty — and then she fell asleep suddenly and stopped breathing. The autopsy ruled out choking, The NY Medical Examiner ruled her death Sudden Infant Death Syndrome (SIDS).

But the NY Medical Examiner (Dr. Persechino) neglected to mention Lyta’s swollen brain or the hepatitis B vaccine in the autopsy report. The coroner spoke to my wife and I and our pediatrician (Dr. Zullo) the day of the autopsy and clearly stated that her brain was swollen. The pediatrician Dr. Zullo’s notes of that conversation are “brain swollen … not sure cause yet … could not see how recombinant vaccine could cause problem.”

SIDS is a diagnosis of exclusion .. “it wasn’t this, it wasn’t that, everything has been ruled out and we don’t know what it was.” A swollen brain is not SIDS. Through conversations with other experienced pathologists, I subsequently discovered that brain inflammation is a classic adverse reaction to vaccination (with any vaccine) in the medical literature.

Every child’s death is tragic, and I regret the Belkins lost their daughter. However, a series of studies have failed to show a link between vaccination and SIDS.

Ah, it’s the return of Proscientifica! You know, the guy who claimed that he was coming to the debate as a newbie and predicting purely from his observations that the BMJ would “obviously” settle with Andrew Wakefield and leave Brian Deer and Fiona Godlee hung out to dry, purely because the evidence, in his disinterested view, was so overwhelming! Then we discovered that Mr. No-Dog-In-The-Fight was the parent of an autistic child who had decided vaccines were to blame. So much for that “disinterested observer” impersonation!

You know, Proscientifica, I didn’t get to mention this to you last time (mostly because your exit with your tail between your legs was too hurried) but there’s a word you and your antivax buddies like to hurl around. People sometimes think the word means “advocating a position and concealing the fact that you’re being paid to advocate it,” but in fact it applies any time someone is advocating a product or cause and concealing the close relationship they have that makes them not a disinterested advocate.

I had the same thought about Kim at AoA. Not only does she have unvaccinated kids with autism, but her articles are absolutely over-the-top. My favorite gem is where she compares pro-vaccine people to baby-killing terrorists:

Liz tells a very sad story.
But people DO move on after tragedy. If they don’t, they probably need to work through their difficulties more realistically through therapy because the event happened MANY years ago.
Altho’ the child’s death might *explain* the position, it doesn’t give them permission to make up tales of malfeasance and give them *carte blance* to mis-lead other parents by disseminating erroneous information.

It would be as if my friends- who lost a parent in a bombing decades ago- came to believe that they can say anything they like in public *because* they suffered this loss. They don’t- altho’ their politics may have been affected by his death.

Of course, those with an anti-vaccine agenda has chosen to support ( and *use*) this fellow who has an emotional COI because they have other types of COIs as well as personal issues themselves..

This topic brings up a bit of a dilemma that comes up with trying to post to anti-vax sites. The comments are generally tightly controlled and few pro-vaccine comments get through moderation.

This means that if you want to correct someone, you either have to make your comment so gentle that it makes it through moderation, or have your comment never show up.

In the past I’ve gone with the first (gentle) approach, but I’m starting to think that the second approach is more effective. I was on the facebook page “Proud Parents of Unvaccinated Children” the other day, and there was a post from a moderator lamenting how much work it was to filter out the shills (ironically, it was soon deleted). I’ve seen this with several anti-vax sites, they generally burn themselves out once they get more traffic. Could that be because they eventually get discouraged filtering out reality?

I don’t know how much you’ve read of the antivax blogosphere,but I would strongly suggest every adult on the spectrum read as much of it as they can stomach.It’s strong poison,you may be only able to take it in small doses at first.

The antivax parents are always talking about how “their kids” are somehow different from every autistic child who was ever born before the MMR.That a severely autistic nonverbal,intellectually disabled child in an institution in the 1950s,could not be as bad off as their child,

It’s one of their core beliefs,right up there with how vaccines “stole” their child,and how their “vaccine damaged” child is less than human.

Given that it mentions the Refusers in passing (some might say “aimlessly”), I will note that the AoA bit “Texas Vaccine Requirements Affect Community College Enrollment” is rather peculiar, in that the 24Medica article that they reference nowhere manages to document this claim in any fashion whatever. Strangely, 24Medica claims this was “Written by Robert Smith,” although the actual work is simply lifted from a Natural News piece bylined “Craig Stellpflug” and simply documented with a link to Infowars. It turns out that the whole thing is predicated on a phone call with an unnamed “whistleblower” that Alex Jones claims to have had.

Now, here’s my question: Why would AoA go to all the trouble of twice laundering their source?

Fauxscientifica, if this document is supposed to be a smoking gun aimed at vaccine safety, you’d better examine it more closely. As a weapon aimed a the heart of your vaccine enemies, it seems to be loaded with blanks. But I have a better idea, let’s let the myriad science folk here give it a read and translate it into layperson for us, shall we?

Nah, but I did just run across this rather odd statement, considering the qualifications of the source, in her Kveller article on fasting for Yom Kippur: “we have access to different parts of our brains when we refrain from food and drink.” Beg pardon?

“Could that be because they eventually get discouraged filtering out reality?”

Of course. It must be terribly difficult to hold onto a false belief unless one can arrange to avoid hearing the truth as much as possible. That’s why anti-vax advocates post on Seth’s blog shouting “SHUT UP SETH” – facts are actually causing them pain. The funniest part about reading Seth’s blog though, is all the antivaxxers who write “I know you’ll delete this, but…” without ever noticing that even the most rabid comments are not deleted.

I’m finding this Prison Planet stuff really amusing. Their video report is here (there’s about two minutes of Bilderberg raving at the beginning). Now, if one makes it to 4:30, they cite Natural News “reporting” a 1997 filler dispatch from Advocate Wire, which itself merely claims an RAI broadcast.

From what I can gather, what actually happened was seizure of a batch of HibTITER over some BSE concern. Note to Prison Planet: Different vaccine. Different pathogen.

With regards to g724, he also more recently suggested in a comment here that criminal activity be undertaken at Mike Adams’ house for some stupid reason or another. His extraordinarily bad idea was immediately responded to by several other regular commentors here noting just how bad and illegal it was.

Considering that he prefaced it with “this might be a little bit edgy for here”, I’m sure the same ethics free person, presumably g724 but who knows, made both comments.

More important, and evidence at how big of giant scum bags the anti-vax people are, the fact is there’s 1 person who makes comments like that here and is immediately addressed by other regular commentors.

Considering the fact that anti-vax people have come here and advocated murder of drug company execs, for example, I’m pretty sure they need to remove the plank from their eyes before worrying about the mote in ours. (or however that goes).

Was it last year that PBS aired the Frontline show about vaccines? When I watched the interviews with J. B. Handley, it struck me how much people project.

It all makes sense to me: I give folks the benefit of the doubt and assume they do the same. But if you’re the person who’s trying to make a buck off of everybody else, who spends his time trying to figure out how to work the system, and is OK with the occasional misrepresentation in order to achieve your goals—yeah, why would you think anyone else is honest?

I was mentioned in the post because g724 made reference to my “tactics”. As if I troll anti-vaccine sites with the same sort of trolling nonesuch I dispense here. I could be accessed of being intemperate with my inanity. Guilty. (now ive got to breal the fouth wall) But as my name might, to some people, indicate, I am not trying to confuse people by espousing extreme views, I am lampooning the extremity to which some Antivaxers take things. My goal is not subterfuge, but snark.

By the way, people, early next week I plan on turning on the setting that sends everyone’s first post through moderation. After that first post is approved by me, then you will be able to post freely. As I said before, it should cut down on morphing trolls and sock puppets. Fear not, however, I will give plenty of warning before turning it on.

@lizditz: Thougj I wasn’t alive at the time I know that an older brother died of SIDS, and from what my parents said nearly tore them apart, so I do know some of the pain they must be going through. As far as I am aware they really haven’t found a cause. I could be wrong though. It just the same as always,for the antivaxxers. the always they must blame something for the death, and as always again it’s the vaccines, as scientific illiterate as they are.
Oh great thingy back for hisannoying and at the same time entertaining idiotic posts.

By the way, Orac, the feature that theoretically lists recent comments to all your posts seems completely broken – it’s showing “desktop on Another defense of the antivaccine propaganda “documentary” The Greater Good from the San Ramon Valley Unified School District” as the most recent comment, and has been showing it as such for days now.

if people are having issues with the recent comments bar not updating, try doing a ‘hard refresh’ by hitting control+shift+r
(command+shift+r on a mac). That should fix it. This works in Firefox and Chrome, not sure about other browsers.

Nope. If one deletes the two cookies that are set upon posting, the recent comments reset to some point on May 22. (This also seems to toss sabots into the “slow down” machine, and not in the helpful direction.)

@thomas, I used to have a very similar problem on PZ’s FTB site occasionally, but with the Opera browser I use on my xoom, clearing the cache used to fix it. Though it hasn’t happened recently. See if your browser has a similar option.

Just wondering something.
It was a total surprise to me when I learned National Geographic had taken over (?),become part owner (?) Science Blogs.They obviously did so,knowing what Thingy,and the other trolls can do to threads at RI.Yet they did so any way.I could see them saying they would take over ScienceBlogs,if they “dumped that ORAC guy.

Enquiring minds are very interested in why an organization like National Geographic would be willing to attatch their names to a blog site that would include RI.ORAC,would you care to enlighten us as to whether this was a problem or not?

Roger,
I went to the Refusers’ site, and that about did me in. I read RI, and the posts from antivaxxers, and I can’t stand the attitude towards children on the spectrum. I also can’t help but take it personally, so I approach such things cautiously. I don’t get why anyone would cling so tightly to such a delusional position, but maybe my neurological difference is why. How can people believe things without evidence? Antivaccine stances have no plausibility or evidence to support them. It’s pure ideology and twisted logic. It’s an emotional lifestyle choice rather than responsible behavior.

I hate listening to people declaiming against their “lost” or “stolen” children, torturing and forcing behaviors to appease the parents’ feelings without any consideration of the children. I feel physically ill. The child is there with his or her feelings and confusion-and I feel so helpless for them suffering at the hands of people who are supposed to be taking care of them. It’s betrayal. I am sorry if I am repeating what others have said but i agree-it’s abuse.
I will try to stay aware as i am able.

Speaking as a person with cerebral palsy, the antivax crowd’s attitude makes me a hell of a lot more sympathetic to the fringe disability activists out there, you know, the ones who basically believe that able-bodied people are trying to kill us all in various ways*, and I hate that, because those particular political gimps are so full of shit they squeak.

And this is the antivaxxers’ attitudes towards their own children. It’s disgraceful. At best.

__________
* This leads them to oppose things like the death with dignity movement, because obviously regulated voluntary euthanasia will automatically restart Aktion T4, natch. Kind of makes me wonder why they hate themselves so much…

Th1Th2: Speaking from personal experience, the unvaccinated kid has a greater chance of developing complications from chickenpox. I was lucky that mine could be quickly treated, but if I’d been older or had delayed seeking treatment for that flareup, I could have risked permanent partial facial paralysis. Am I going to get the shingles vaccine the moment I’m eligible? Damn straight I am.

Herpes zoster (HZ), or shingles, is caused by reactivation of latent varicella-zoster virus after a primary infection with either wild-type or vaccine-type varicella-zoster virus, the latter having been introduced in 1995 for children.

If you traipse over to the Refusers’ website, you’ll see some very interesting comments posted in the last 26 hours or so…enough said.

In other news:

Anne Dachel @ AoA informs us that doctors don’t know how to diagnose autism… should I infer that *she* does?

A writer @ Natural News tells us that we might indeed avoid the repercussions of the fast-approaching economic Gotterdammerung-Ragnarok if ONLY we sink all of our money into gold and silver… seems I’ve heard this before somewhere….
many times…

It’s working fine on my browser. Actually, both the recent comments and recent posts features are working fine on my browser.

It is not working with Firefox, and when I was on a very patient access terminal with restrictive settings at a hospital I would not have had freedom to change browsers. So that should be fixed. Along with getting “Next page/Previous page” button, darker comment font, and number of comments on front page.

(Yay! We are home… now making followup medical appointments. It was very nice to have mobility assistance at the airports.)

I have a hypothesis about the past few years wherein the rants have up-ticked way beyond 11:

post Sept 2008, woo-meisters were afraid that consumers’ rapidly declining fortunes – more accurately- consumers’ *perceptions* of their rapidly declining fortiunes- would affect sales negatively
thus, they needed to ramp up the conspiracies and tales of malfeasance perpetrated by SBM/ pharma in order to get marks to buy more of their crap- how much they need to preserve their health in hard times. They could also capitalise on the free-floating anxiety out there.

Needless to say, the marks’ were deleteriously influenced by the increased shrieking and imitated their woo-meisters’ parlance and modes of ( nearly absent ) thinking. Now, it has become standard.

Thingy, do you recall the question you actually asked, whether unvaccinated or vaccinated children are at greater risk of developing shingles? As the incidence of shingles in unvaccinated populations is greater than the incidence Tseng found in vaccinated children (122 in 172,163, or 0.07%), VZV vaccination reduces one’s risk of developing shingles.

Why should I have to make a comment in order for the recent comment list to update? And how come Brian was able to put in a second comment after a couple of minutes, and I could not after a full half hour?

Am I going to get the shingles vaccine the moment I’m eligible? Damn straight I am.

You were already eligible for shingles that moment you had the chicken pox and that goes to all children as well who had received primary varicella vaccination. The shingles vaccine is nothing but reinfection. Bet your house.

Again, I forgot this is RI. I may have to speak their language. The shingles vaccine is a “booster” reinfection.

Just ’cause I need to make some sort of post so that the sidebar starts updating:

An unvaccinated child who gets wild-type VZV is three times more likely to get shingles than one who was vaccinated.

At current vaccination rates, of the vaccinated children who get shingles, 40% get shingles from wild-type VZV, not the vaccine.

Half of the cases of chicken pox reported in the first six weeks following vaccination were actually caused by wild-type infections.

Immunocompetent vaccinated children almost never spread vaccine-type VZV. Less than 10 cases have been reported in the US and Japan combined, and in each case, the spread was limited to people living with the vaccinee.

An unvaccinated child who gets wild-type VZV is three times more likely to get shingles than one who was vaccinated.

Unless you really believe that 0 is greater than 1. Now can you tell me why the unvaccinated cannot possibly have the shingles?

At current vaccination rates, of the vaccinated children who get shingles, 40% get shingles from wild-type VZV, not the vaccine.

That only means to say 40% have previously had natural varicella infection prior to their receipt of varicella vaccine. So what’s the dillio? Shingles is NOT caused by secondary exposure or reinfection to VZV, in this case, the vaccine. But what about those children whose primary exposure to VZV is thru primary varicella vaccination. Again what’s the current vaccination rate for varicella? You tell me.

Half of the cases of chicken pox reported in the first six weeks following vaccination were actually caused by wild-type infections.

Again, by whatever means the vaccinated got re-infected by VZV, wild-type or otherwise, is immaterial since shingles is NOT caused by reinfection. What made these vaccinated living candidates for shingles is because of primary varicella vaccination.

Immunocompetent vaccinated children almost never spread vaccine-type VZV. Less than 10 cases have been reported in the US and Japan combined, and in each case, the spread was limited to people living with the vaccinee.

I hadn’t gotten around to this one. The presence of Gravatar is bad enough (it is, after all, nothing but a data-mining operation), but the MD5 hash of your E-mail address isn’t all that secure. Basically, if one is privacy-concerned, a different address should be used for every Gravatar-enabled blog that one visits.

@ Denice Walter: Well thanks so much for pointing out that some of the RI ladies have been labeled as “Pharma Sluts” by CIA Parker…because the RI ladies have called her out for being a pathological liar. (Kelly, I think that CIA has “decided” you are a female)

I’ve been terribly remiss by not posting back at CIA…consequently, I’ve not been identified as a Pharma Slut (sigh).

@ Chris: I’m happy to hear you and your son are back home…I’m sending best wishes to your fella for a speedy recovery.

Well, the nice thing about the gravitar is that I recognize people more easily if they have a common name (Chris, for example). There is a feel to the posts by the real ones, but, OTOH, it makes it harder for people to sockpuppet you, especially is the picture (like mine) is personal. Not saying it isn’t possible, just that it isn’t as easy.

Well, the nice thing about the gravitar is that I recognize people more easily if they have a common name (Chris, for example).

Sure, but there’s no requirement to use Gravatar per se. This could be hosted locally. Indeed, one could have the choice of allowing Gravatar in or not. And if you’ll excuse me, I now have to put on Randy Newman’s version of “My Old Kentucky Home” and laugh myself silly.

Wow. New blog site, same old stupid burning my eyes. Orac, I don’t know how you do it, but I’m glad you’re still out there. Hardcore science beats the gullibility and oh-woe-is-me that seem to afflict so many in the anti-vax crowd. Or perhaps it’s just an innate inability or unwillingness to understand things like statistics, biology, and genetics. All of which would point to something other than vaccines as the cause of autism, though they may not all point in the same direction. I think it’s multifactorial, personally, but vaccines have little if any connection. It doesn’t help that the very definition of what constitutes “autism” is a moving target.

@Johnny
And therein lies the problem. Believe it or not, it possible, with effort and patience, to back her into a corner about one of her ‘facts’ – but as soon as you manage to do that, she switches to the other one, and goes on her merry way.

For all you stealth pro-vaccine enthusiasts out to infiltrate antivax discussions with unfair heartrending stories, the best can be found at pkids.com (Parents of Kids With Infectious Diseases) and this site:

Antivaxers hate parents’ stories about their children who were harmed by vaccine-preventable diseases. They think the anecdote franchise has been reserved for themselves alone, and being topped by logical and well-documented personal stories drives ’em nuts.

It probably beats dry statistics and hard-to-comprehend research as a method of persuading the undecided.

Anne Dachel @ AoA informs us that doctors don’t know how to diagnose autism… should I infer that *she* does?

Of course she does DW… it’s the vaccines. Did you get a load of her hand-wringing over the proposed risks for autism? Pre-natal environment is somehow “mother-blaming” ala Bettleheim. They don’t want to have anything to do with any causation or risk model that makes them feel guilty. Ever.

First of all, personal apologies to Orac for having indirectly caused what appears to be the waste of a bunch of your time.

Second, yes, I do advocate “gray ops,” the rules for which are: 1) No violence, 2) nothing more illegal than peaceful sit-ins, littering, or data spills, 3) aside from those limits, do whatever works.

I’ll make my case for this once for the record, and then drop the subject forevermore around here since it appears to be unwelcome in this forum:

Count up the deaths due to vax-preventable outbreaks recently. Compare to the deaths from the anthrax letters in October 2001. Also consider the cases of whooping cough, well over 1,000, in Washington State, a few thousand more in California where I am sitting while writing this. And consider the nutjobs who are actively sending chicken pox contaminated material through the US Mail to “share it” for “natural immunity,” creating a risk of infecting postal workers and cross-contaminating other items of mail. Taken together this stuff adds up to the equivalent of bioterrorism.

In the face of that, I believe that gray ops are justified, right up to but not one millimeter beyond the point where law enforcement steps in to prosecute the deliberate spreaders of disease. Vigilantism is what happens when government is unable to protect people from a threat; but the moment government steps in to do so, vigilantism must stop, for the very pragmatic reason that it may interfere with law enforcement investigations and prosecutions.

Faked posts on antivax blogs don’t make anyone sick and don’t kill anyone. For the anti-vaxers to assert some kind of moral equivalence is as bogus as when Faux News turns science into a he-said/she-said story where every fact is an opinion and every opinion is given equal weight (e.g. climate denialism, creationism, etc.).

Two things appear to have happened as a result of all of this:

One, my posts made it back to the anti-vaxers and will spread like viral memes in their midst, ratcheting up their paranoia level to near meth freak levels if it isn’t there already. They will freak out over anyone who tries to post on their sites with even so much as a tiny deviation from their orthodoxy. They will fanatically spell-check and grammar-check every comment to avoid the risk that people such as yours truly will post bad writing that makes ’em look stoopid. They will go into auto-immune overdrive to purge themselves of any hint of anything that could remotely look like it could be part of a gray op. In doing so they’ll tick off some of their own constituency. So either way, they end up fighting themselves. Yee-hawww! to that.

But here’s the really significant part, the proverbial dog that didn’t bark.

Notice what they left out of the quotes they so liberally lifted from here.

They left out the parts where I described how to get them busted by law enforcement. For example turning in pox-mailers and their enablers to the US Postal Inspection Service.

And this, I submit to you, is because they read it and they’re truly scared that it’s going to start happening. You can be sure that the word is going out to all their affiliated walking vectors to be a little more discrete in case the Feds come knocking. Goodie! Hope it slows ’em down and deters any more pox-mail among other things.

And in case they’re reading this comment, they should understand something: The thing that others here have taken me to task for, which I am not going to do around here any longer, is the promotion of psychological warfare tactics.

But the thing nobody here has criticized and a few have specifically supported, is getting anti-vaxers, pox-mailers, and the like investigated by law enforcement and prosecuted for whatever crimes can be demonstrated (from which there are many to choose).

So all those increasingly-paranoid anti-vaxers out there should understand this: there is no disagreement about sending the law after them. May they have many a sleepless night wondering if that’ll be the night they get awakened at 4AM to be served with warrants.

You see how they mis-represent what you wrote – leaving out salient points and the context in which you’re writing ( altho’ they do link). This is similar to how they quote and misrepresent scientific articles and studies. It’s their way-of-being. Not the first time I’ve seen this occur.

I have no idea how they’ll react emotionally – you may be correct or like a well-known woo-meister says, they might assume that sceptics are becoming desperate because they realise that ” their days are numbered”. In fact, some people @ AoA and other places, believe that the medical establishment is soon to crash unceremoniously into the dirt from whence it sprung.

I know of two great guys whose scepticism interfered with their lives- they wrote on the internet and spoke publicly against nonsense masquerading as new science/ natural health under their own names: one got harassed at work and at home and the other was sued for a total of 13 million USD! It was thrown out of court but it took 2 years out of his life- probably cost him money too. The other decided to give up his blog.

The anti-vaccine movement is invested in their activities and believe that they are justified in their own often despicable behaviour. I would not expect them to play fair. After all, they see ‘vaccinationists’ as evil and totally corrupt.

I can speak only for myself- I think that I have data to back up my beliefs and that history is on my side. While I cautiously leave off my second surame and location, I don’t misrepresent myself.

I just would be careful if I were you- I think that your heart is in the right place altho’ I might disagree with your means.

Th1TH2: I’d like to point out that I acquired chicken pox just like everyone else in my age group- from the natural, pure 100% varicella. So raving about how I acquired it from the vaccine is even more nonsensical than usual. And again, you don’t really understand how vaccines work. Did you even graduate from high school?

Th1TH2: I’d like to point out that I acquired chicken pox just like everyone else in my age group- from the natural, pure 100% varicella. So raving about how I acquired it from the vaccine is even more nonsensical than usual.

Your failure to comprehend is really astonishing. Again, you’ve become a shingles candidate after you have had primary varicella infection. For those clueless pro-vax who are still wondering what a primary varicella infection is, your first or initial exposure to VZV. In the real world, that would be either natural varicella infection or primary varicella vaccination. WHICHEVER COMES FIRST. Since you’ve already acquired the wild-type VZV in your system, a shingles vaccine, which is also a chicken pox vaccine for the first-timers, is “even more nonsensical than usual” . What are you trying to prevent? You tell me. After that, I’ll tell what you’re really trying to promote.

And again, you don’t really understand how vaccines work. Did you even graduate from high school?

The vaccine VZV ends up in the dorsal root ganglion where it remains dormant until it reactivates as shingles. Like you in high school, the varicella vaccine is nothing but a troublemaker. Make sense?

FFS, we have all been around the bend with Thingy and her Thinglish. She’s a horrid ditchpig without a shred of intellectual honesty. Will you all just stop engaging?! She’s an insufferable attention-whore who will hijack threads until they are unrecognisable.

What part of “boy-in-the-bubble land” did you not understand? *Yawn*. Haha, move on. Geez. It’s very predictable. You are barking up the wrong squirrel. Don’t gamble more than you can afford to lose. I smell fish. Next.

I’m afraid you didn’t read my question. Assuming that VZV is already present, is there value in preventing reactivation?

Let’s cut to the chase. The shingles vaccine does NOT prevent VZV reactivation.

Zoster vaccine acts by boosting declining levels of preexisting CMI to VZV in older adults, thereby reducing the frequency and severity of a disease caused by reactivation and multiplication of endogenous latent VZV.

TH1 TH2: Obviously, I want to prevent a flareup again. The shingles is already present in my system, so I want to convince my immune system to keep suppressing it. A vaccine will do that, especially if I get pregnant. And I can’t get rid of the ’cause’ unless time travel gets invented.
Nichegeek: The value- to me at least- is that I don’t have to spend two weeks worrying that my face will return to normal, and that I don’t have to stick to soft foods for the rest of my life. Not to mention the sensitivity to cold (we had blizzards that year, fml) or the hearing sensitivity.

TH1 TH2: Obviously, I want to prevent a flareup again. The shingles is already present in my system, so I want to convince my immune system to keep suppressing it. A vaccine will do that, especially if I get pregnant. And I can’t get rid of the ’cause’ unless time travel gets invented.

How many VZV vaccines do you need for you to understand that repeated “booster” reinfections like the shingles vaccine or re-exposure to natural chicken pox do not suppress pre-existing latent VZV infection?

You may very well talk to your conscience instead of your immune system, infection promoter. Now do try to learn from your mistakes. And please remember, DO NO HARM to others especially if it is your baby.

SOME ends justify SOME means, which is NOT the same thing as “THE (unlimited indefinite article) ends justify THE (ditto) means.” Nobody, including yours truly, is advocating doing to antivaxers what the religious right routinely does to gynecologists and womens’ health clinics.

If you think that paranoid conspiracy theorists can be persuaded with facts & evidence, I applaud the idealism even if it’s misplaced. Facts & evidence reach open minds. For dealing with the committed fanatics of truly dangerous BS, other means are needed. If gray ops are unwelcome here, I would at least hope that promoting electoral solutions is welcome here, because that’s another route to dealing with this.

Denise:

If they think “the medical establishment” is about to crash & burn, good! Excellent! Let them keep thinking that, while SBM keeps making progress and more people keep getting the results they seek from SBM.

Sorry to hear about the bloggers whose 1st Amendment rights got squished by woo-meisters; I’m careful enough to have effectively zeroed out my risks in that department. But I’ll happily obfuscate my biography on the basis that a) ideas stand or fall on their own merits, and b) with the exception of “war mode,” I don’t hang out in places where I can’t abide playing by the rules. That said, I’m contemplating letting the G724 identity die of natural causes, and using another pseudo here, by way of not giving the antivaxers any more of my comments to feed on. Orac may be able to see the transition but everyone else will just see an absence of G724 and the appearance of someone else.

To my mind the bottom line is “power politics” no matter how one cuts the proverbial cake. When dealing with people who are an acute and immediate hazard to others, the first priority is to protect the innocent others. It’s like dealing with would-be drunk drivers: “take the keys” is an exercise of power because it physically prevents them doing what they wanted, which was to get behind the wheel.

OK, I just checked in on another column here and see that G724 is still “an issue,” and still wasting some of Orac’s time, which is not cool. So at this point I’m pretty sure I’m going to let that identity die, and come back in a form that does not generate controversies.

Thanks. I’m fully aware of the benefits and I knew I was likely “barking up the wrong squirrel” however I had to try. Th1Th2 never seems to grasp that her advice amounts to “Doctor, it hurts when I raise my arm” “then stop raising your arm”

When dealing with people who are an acute and immediate hazard to others, the first priority is to protect the innocent others. It’s like dealing with would-be drunk drivers: “take the keys” is an exercise of power because it physically prevents them doing what they wanted, which was to get behind the wheel.

See, notifying postal inspectors of posters who state their intentions to send biohazardous material through the mail, that’s analogous to taking the keys away from a drunk person who wants to drive home. Most of the “gray ops” you propose are more analogous to lying to the other guests at the party and telling them that the drunk person who’s leaving for his car is such a psychotic dipsomaniac that he spiked the punch with alcohol he filtered from Sterno. It doesn’t do a damned thing to stop the person who’s going out to drive drunk, and when the people you’re spreading these lies to realize that you’re lying, their reaction is going to be “Wow, you can’t trust anything that liar says. I mean, I don’t even know if I believe Sully was drunk, now know that I know the guy accusing him of being drunk is a total psycho liar!”

Plus, I feel this bears repeating:

By the way, by asserting that “when dealing with hard-cores who are an overt threat to public health, any nonviolent tactic is legitimate”, do you realize that you’re endorsing the efforts of antivaxxers to try and jeopardize the jobs of Orac and Ren and others? Endorsing the slanderous lies that Tim Bolen tells about Stephen Barrett? Endorsing every antivaxxer who knowingly lies and pretends “Paul Offit wants every infant to be injected with 100,000 vaccines at once!!”? Endorsing those who Photoshopped the enemies of AoA as cannibals sitting down to a Thanksgiving feast of babies? Every one of those reprehensible acts was, in the eyes of its perpetrator, a nonviolent tactic for dealing with a hard-core who’s an overt threat to public health.

I really hate your delusions of grandeur, g724. You have this vision of yourself as one of the few people who really knows to take effective actions, and of everyone who tries to say “What?! Hell no, that’s a bad idea!” as too “naive” to understand what you do about playing “hardball.”

But the reality is, your “effectiveness” exists entirely in your own imagination. Like the muddled thinkers who with a straight face intoned “we had to destroy it in order to save it” you take the very evidence of your failure and try to interpret it as success. “See! Before, the antivaxxers could only allege that mainstream medicine was engaged in underhanded dirty tricks campaigns against the antivax movement! Now, they have actual proof that such dirty tricks campaigns against them are planned by provax forces, proof they can blow out of proportion by ignoring the fact that it all comes from just one person!

“Hooray! That’s victory, because it increases the antivaxxers’ paranoia! And that will surely be in our favor, because the same people who might have bought into antivax conspiracy theories with nothing to support them will surely be turned off and turned away by antivax conspiracy theories with supporting evidence for the perfidy of provax forces handed to them on a silver platter!”

As I’ve said before, if you really want to help the cause of fighting disease, let the g724 identity and all his little-boy fantasies of being a Psy Ops warrior disappear. Considering all the effect he’s had, and for which side, J.B. Handley should be sending him a check and congratulations.

I write about how woo portrays itself as being pure as the driven snow while painting the Establishment as a tissue of lies, running upon scullduggery and malfeasance.. all of which is ADVERTISING and disruptive camouflage for their own actions…
A so-called documentary will soon appear that details SBM’s TYRANNY over the People. Right.
Now if I would to engage in any unseemly and dishonest activities , wouldn’t I be *seconding* their motion and proving their point?
No. Uh-uh. They produce claptrap and that’s what I’ll call it.

Thanks. I’m fully aware of the benefits and I knew I was likely “barking up the wrong squirrel” however I had to try. Th1Th2 never seems to grasp that her advice amounts to “Doctor, it hurts when I raise my arm” “then stop raising your arm”

There are two things in your statement that are true.

1. You were “barking up the wrong squirrel”.
2. You knew the doctor caused the pain.

Niche Geek, I once patiently explained to Thing-troll that if we had a method for reducing the chances of an individual contracting an infectious disease, and a sufficient number of people in a population used that method, it would produce the effect we call “herd immunity,” and nothing was dependent upon the method of individual protection being a vaccine.

She replied claiming that my “analogy” was faulty because I didn’t specify that the method of individual protection was filthy and dangerous. My “analogy,” she said, could not be accurate unless whatever was hypothetically used instead of vaccines was “as bad as vaccines.”

It doesn’t matter if she’s truly crazy or just pretending; she’s too crazy for talking to her to do any good.

Practically you’re in the bargaining stage, Antaeus. Once, you’ve inoculated and infected the naive with live VZV, you are NOT reducing the incidence of primary VZV infection let alone the incidence of shingles. In short, you are NOT protecting the “herd”. You just cannot reverse nor manipulate the facts by giving false reassurance. It is not therapeutic. Sorry, dude. You_are_an_infection_promoter!

Really, the Thing-dong is like the broken record you should have thrown out, but you like the funny warbling that it makes and so you can’t quite get rid of it. Don’t forget to mark your bingo cards, we already have “infection promoter” now I am waiting for “AFP = polio” to work on my full card!

She has one very weird link on the ShotOfPrevention blog that makes absolutely no sense.

Why Chris? Are you not old enough to remember this:

In 1936 there was an ultimately lethal competition between two would-be vaccine inventors, Maurice Brodie at NYU and John Kollmer at Temple University. Brodie concocted a “vaccine” from an emulsion of ground-up spinal cords of infected monkeys. He attempted to deactivate the virus by exposing the vaccine to formaldehyde, phenol, and polio antiserum. He tried the vaccine on twenty monkeys, and with that woefully inadequate experimental base conducted a human trial with three thousand children. The vaccine was a little or no value and was associated with sever side effects. His research career was destroyed, and he later killed himself.

Even worse was Kollmer’s vaccine. He attempted to attenuate polio virus obtained from monkey spinal cords. He created a stew of spinal cord tissue and various chemicals and refrigerated the mixture for two weeks. He used it on a few monkeys, himself, his children, and twenty-two others. He was so convinced of the value of his vaccine that he distributed thousands of doses to physicians around the country. The vaccine caused many cases of polio, some fatal. It probably had no value as a vaccine. At a medical society meeting in 1935 he said, “I wish the floor would open up and swallow me.” From: The Vaccine Controversy: The History, Use, And Safety Of Vaccinations, p 90-91

So who’s John Salamone again, Chris?

The vaccine trials of John Kolmer and Maurice Brodie had a chilling effect on polio vaccine research. Twenty years passed before anyone dared to try again. From: The Cutter Incident:
How America’s First Polio Vaccine Led to the Growing Vaccine Crisis

How I wish the floor would open up and swallow this author- “Twenty years passed before anyone dared to make the same mistake again!”

VAPP was defined as occurring in AFP cases if there was residual weakness 60 days after the onset of paralysis, if vaccine-related poliovirus was isolated from any stool sample, and if no wild poliovirus was isolated from any stool sample.

I was a lurker for a long time and I know I shouldn’t address Th1, but it is sooooo hard to resist the urge to respond. I work with a lot of people for whom English is a second (or subsequent) language and I delight in some of their interesting alternative grammar and vocabulary choices but Th1 is simply magical.

I can’t seem to find the old comments, which is annoying, because I’d like to be able to link to the moment when Th1Th2 decided to tell the parent of an autistic child what she really thought. Maybe she’ll tell us here.

Thingy, I realize it’s probably futile to engage with you, but your extreme anti-vaccine position raises one question that demands an answer:.

What exactly do you propose we replace routine vaccination with? Is your preferred situation one where we no longer immunize, and where instead we accept millions of people worldwide will die every year from the diseases vacines now protect against?

I can’t seem to find the old comments, which is annoying, because I’d like to be able to link to the moment when Th1Th2 decided to tell the parent of an autistic child what she really thought. Maybe she’ll tell us here.

Many of whom who have had primary varicella infection either from the vaccine or natural infection will become infectious again as shingles even if you completely stop vaccinating the people right now. Therefore the naive will still remain susceptible to varicella infection until the remaining infection promoters are gone from the face of the Earth. The good thing is no one is calling for a shingles party…yet.

So your answer is to simply let millions of people (mostly children) needlessly die every year, of vaccine preventable diseases like measles, pertussis, smallpox, etc.?

Speaking of “needlessly” . I know you know that the lack of basic needs not to mention the lack of physiologic needs is the number one killer in the world today. The number one killer in the US is not poverty but medical iatrogenesis.

Moral response and due diligence, not “immune” response, infection promoter.

Over at Mothering.com, a (l)user named Taximom5 started a thread titled Warning: Sock puppets and pharmashills on various forums in which she quoted pretty much the same comments by 724 that Belkin of The Refusers did, and like Belkin, she pretty much ignored all the comments telling g724 to cut the crap.

Well, someone there called her on it, a user named “WildKingdom,” who pointed out that the response to g724’s cloak-and-dagger routine had been pretty uniformly negative, and quoted several critical comments to make that point.

Taximom5 then proceeded to claim that there had been numerous “amen, brother” comments applauding g724’s suggestions, but they must have been sneakily edited out since the last time she visited the page. Because, y’know, we can edit our comments on ScienceBlogs. Don’tcha see the big “edit” button next to every comment we post??

Taximom5 also proceeded to spin-doctor the response of yours truly, who had been heavily quoted as one of those speaking out most vehemently against g724’s cloak-and-dagger routine. She quoted some things I’d said to g724 about why his proposed dirty-tricks campaign was likely only to backfire, especially if he was stupid enough to keep discussing his proposed “gray ops” in public, and concluded:

In other words, it’s not the trolling Mr. Feldspar objects to, it’s the fact thatg724 clumsily announced his plan on a public website.(emphasis in original)

Unfortunately for Taximom5’s theory, the first quote that she takes from me to claim that “it’s not the trolling that Mr. Feldspar objects to” is only the first half of a paragraph, and this is the second half:

“Any nonviolent tactic is legitimate”? Bull5hit. Even people you disagree with have rights, and they are rights that do not stop at “the right to not be subjected to violence.” If you show that you don’t understand that very simple principle, why would anyone think you understand the much more complicated subject of immunology.

and the paragraph immediately following:

By the way, by asserting that “when dealing with hard-cores who are an overt threat to public health, any nonviolent tactic is legitimate”, do you realize that you’re endorsing the efforts of antivaxxers to try and jeopardize the jobs of Orac and Ren and others? Endorsing the slanderous lies that Tim Bolen tells about Stephen Barrett? Endorsing every antivaxxer who knowingly lies and pretends “Paul Offit wants every infant to be injected with 100,000 vaccines at once!!”? Endorsing those who Photoshopped the enemies of AoA as cannibals sitting down to a Thanksgiving feast of babies? Every one of those reprehensible acts was, in the eyes of its perpetrator, a nonviolent tactic for dealing with a hard-core who’s an overt threat to public health.

Funny, those don’t sound to me like I’m saying “trolling people is A-OK; just don’t admit you’re doing it!!” Although I suppose Taximom5 would claim that I must have gone in after she quoted me, and added those parts that criticized more than just the practical aspects of g724’s plans.

Well, on the one hand, I was pleasantly surprised that she did get called out on her hit job. OTOH, the whole thing reminded me unpleasantly of Wikipedia arguments where the issue of whose facts are correct is clear, but gets utterly lost in a debate about whose behavior adhered the most fervently to the arcana of the social rules.